Apathy in Parkinson's disease: diagnostic and etiological dilemmas.
Identifieur interne : 000E84 ( Main/Exploration ); précédent : 000E83; suivant : 000E85Apathy in Parkinson's disease: diagnostic and etiological dilemmas.
Auteurs : Sergio E. Starkstein [Australie]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2012.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- diagnosis : Parkinson Disease.
- drug effects : Apathy.
- etiology : Parkinson Disease.
- methods : Deep Brain Stimulation.
- physiopathology : Parkinson Disease.
- therapy : Parkinson Disease.
- Humans.
Abstract
About one-third of patients with Parkinson's disease (PD) are diagnosed with apathy in cross-sectional studies. However, once patients with concomitant depression and dementia are excluded, the frequency of apathy drops to 5% to 10%. Several scales have been recommended to rate apathy in PD, but specific psychiatric interviews have not been developed, and recently proposed standardized diagnostic criteria are still in the validation process. Most studies assessing the association between subthalamic deep brain stimulation (STN-DBS) and apathy have reported a relative increase in the frequency and severity of apathy, although discrepant findings have also been reported. Several mechanisms to explain apathy in PD have been proposed, from dopaminergic imbalances in frontal-basal ganglia circuits to dysfunction of nondopaminergic circuits and the cingulate gyrus. Future studies should provide reliable and valid instruments to diagnose apathy in PD, and should examine the mechanism of apathy accounting for relevant confounders, such as depression and cognitive deficits, and important contextual factors. Finally, treatment for apathy in PD should not be restricted to psychoactive drugs, but should also include nonpharmacological techniques such as psychotherapy and occupational therapy.
DOI: 10.1002/mds.24061
PubMed: 22237755
Affiliations:
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Le document en format XML
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Starkstein</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia. ses@cyllene.uwa.edu.au</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia</wicri:regionArea><wicri:noRegion>Western Australia</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="doi">10.1002/mds.24061</idno><idno type="RBID">pubmed:22237755</idno><idno type="pmid">22237755</idno><idno type="wicri:Area/PubMed/Corpus">000F04</idno><idno type="wicri:Area/PubMed/Curation">000F04</idno><idno type="wicri:Area/PubMed/Checkpoint">000F42</idno><idno type="wicri:Area/Ncbi/Merge">003526</idno><idno type="wicri:Area/Ncbi/Curation">003526</idno><idno type="wicri:Area/Ncbi/Checkpoint">003526</idno><idno type="wicri:Area/Main/Merge">000F32</idno><idno type="wicri:Area/Main/Curation">000E84</idno><idno type="wicri:Area/Main/Exploration">000E84</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Apathy in Parkinson's disease: diagnostic and etiological dilemmas.</title><author><name sortKey="Starkstein, Sergio E" sort="Starkstein, Sergio E" uniqKey="Starkstein S" first="Sergio E" last="Starkstein">Sergio E. Starkstein</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia. ses@cyllene.uwa.edu.au</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia</wicri:regionArea><wicri:noRegion>Western Australia</wicri:noRegion></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents (therapeutic use)</term><term>Apathy (drug effects)</term><term>Deep Brain Stimulation (methods)</term><term>Humans</term><term>Levodopa (therapeutic use)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (etiology)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Apathy</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">About one-third of patients with Parkinson's disease (PD) are diagnosed with apathy in cross-sectional studies. However, once patients with concomitant depression and dementia are excluded, the frequency of apathy drops to 5% to 10%. Several scales have been recommended to rate apathy in PD, but specific psychiatric interviews have not been developed, and recently proposed standardized diagnostic criteria are still in the validation process. Most studies assessing the association between subthalamic deep brain stimulation (STN-DBS) and apathy have reported a relative increase in the frequency and severity of apathy, although discrepant findings have also been reported. Several mechanisms to explain apathy in PD have been proposed, from dopaminergic imbalances in frontal-basal ganglia circuits to dysfunction of nondopaminergic circuits and the cingulate gyrus. Future studies should provide reliable and valid instruments to diagnose apathy in PD, and should examine the mechanism of apathy accounting for relevant confounders, such as depression and cognitive deficits, and important contextual factors. Finally, treatment for apathy in PD should not be restricted to psychoactive drugs, but should also include nonpharmacological techniques such as psychotherapy and occupational therapy.</div></front></TEI><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Starkstein, Sergio E" sort="Starkstein, Sergio E" uniqKey="Starkstein S" first="Sergio E" last="Starkstein">Sergio E. Starkstein</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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